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Use Tramadol as prescribed by your doctor. It is recommended to take Tramadol orally with or without food. Phentermine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.   It may not be a complete list of all interactions with other drugs. To prevent any complications you should check with your health care provider before you start, stop, or change the dose of any medicine. Anticholinesterases (eg, pyridostigmine), aspirin, methotrexate, mifepristone, ritodrine, water pills (eg, hydrochlorothiazide, furosemide), or Sleeping pills, tranquilizers, sedatives, and antihistamines may increase drowsiness. Use them only under the supervision of your doctor. Consult with your doctor in case you experience signs of infection like fever, sore throat, rash, or chills.

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